There have been plenty of stories detailing how difficult it is to treat the morbidly obese.
Most of the time, the stories have centered on simply how difficult it is to transport these patients to the hospital.
Once there, however, emergency physician Shadowfax talks about other issues. For instance, obtaining IV access is near impossible, and 500+ pound patients present grave challenges to securing an airway, managing ventilation, or performing …
This ER in Atlanta is betting that you will.
Taking advantage of worsening patient wait times in emergency departments, the Emory Adventist Hospital is offering a “Hold my place in line” service.
For a fee of $24.99, patients are guaranteed to be see in 15 minutes or less – or the entire visit is free.
It seems to me like shrewd business, and the blatant beginning of tiered emergency service. However, WhiteCoat …
The Mayo Clinic has been touted by policy wonks as a low-cost, high-quality integrated health system that American physician practices should aspire to.
What’s somewhat less publicized is that they are also a leader in so-called “executive physicals.” (via Schwitzer)
These exams, which often exceed thousands of dollars, offer CEOs and other executives a battery of tests that are often not evidenced-based. These can include stress tests, cardiac CT scans, and …
Donald Berwick is a physician at the forefront of the patient empowerment movement.
In a recent interview, he believes that medical care needs to be more patient-centered, in effect, “transfer[ring] control from doctors to the patients themselves,” and, “patient preference occasionally putting evidence-based care “in the back seat.”
I wonder how, as a pediatrician, he’s handling the anti-vaccine movement.
In response to a question on patient choices that come in conflict with …
The fight versus anti-vaccine proponents is a losing one.
Orac, a general surgeon who blogs over at Respectful Insolence, is on the front lines of the debate. In this post, he writes about how vaccine supporters are facing an uphill battle:
One problem is that vaccines have been so successful that parents rarely see the full, ugly consequences of the diseases against which vaccines defend anymore. The other problem is that …
There has always been an underlying tension between obstetricians and midwives.
From the doctor’s side, the only times they interact with midwives is when trouble arises. Or, as this article in Time puts it, “When hospital-based obstetricians see midwives and their clients it’s usually because something has gone wrong . . . OBs don’t see the uneventful births that proceed successfully at home [and] doctors in this position find themselves …
A hospital that denied a woman from visiting her dying partner at a hospital is now at the center of a federal lawsuit.
Tara Parker-Pope details the case, which is sparking outrage. I won’t rehash the discussion, which has been quite vigorous over at her blog. Indeed, the results of the pending lawsuit can have far-ranging effects, including “the way hospitals treat all patients with non-marital relationships, including …
When it comes to influence, you need not go further than Oprah Winfrey.
Just ask Kentucky Fried Chicken.
With the recent news that she is giving anti-vaccine proponent Jenny McCarthy prominent airtime, as well as her previous endorsement of Suzanne Somers’ book on “bioidentical hormones,” is she doing more harm than good?
That’s what Rahul Parikh suggests in a piece on Salon. Despite her soaring ratings captive audience, Dr. Parikh thinks that, …
A recent poll conducted by the Consumer’s Union, publisher of Consumer Reports, found that only 4 percent of patients said their doctors talk with them about the cost of prescriptions. And 60 percent find out what the price is for the first time when they pick up their drugs at the pharmacy.
Should doctors discuss the price of medication before prescribing it?
As physicians, we’re trained to make treatment decisions without the …
But can that be a good thing?
More patients have higher deductible health insurances, making them question the costs of emergency room tests and treatments. The fear of sticker shock is causing some to leave the hospital against medical advice.
In fact, discharges against a doctor’s advice jumped by almost 50 percent over the last decade.
Such cases can range from patients not willing …
Transplant surgeon Pauline Chen uses that harrowing personal account to discuss the intersection between motherhood and medicine.
Women currently make up the majority of students at most medical schools, which means that female physicians will comprise a major part of the future medical workforce. But, despite the stress that you’d intuitively associate between juggling medicine and raising children, “work-family conflicts were not a major source of stress …
The physical exam is increasingly being overlooked, and replaced by diagnostic tests, which are easier, and take less time, to order.
At this new blog over at The Atlantic, Abraham Verghese talks about how the physical exam, when done well, “earns the trust of the patient, and it also lays the foundation for the patient-physician relationship.”
However, when done poorly, “it does the opposite–it creates …
Yes, cash can transmit the flu.
In an interesting report (via Well), it’s noted that the flu, including the H1N1 virus, can last for as long as an hour on money and other forms of paper currency. Worse, “mix in some human nasal mucus, and the potential for the virus to hang on long enough to find a victim increases, according to one of the few …
Prior to a breast or bone marrow biopsy, intravenous sedation is typically offered to, and accepted by, patients.
But, what if some don’t really need such heavy sedation?
Over at Better Health, Harriet Hall wonders if some patients would do just fine with a simple local anesthetic: “Has it become a knee-jerk reflex to sedate everyone as a general principle? Why? To avoid complaints and keep patients …
Coverage on the H1N1 influenza has been nothing short of constant.
But, how is it affecting your physician’s office? For me, there’s been many questions, some patient anxiety, and lots of diagnostic nasal swabs. But, being in New Hampshire, the prevalence of the H1N1 virus has been relatively low, compared to other parts of the country.
For a more detailed look behind the scenes, Rob Lamberts …
Abraham Verghese will be answering your questions at my next live Q&A.
Dr. Verghese, a Professor for the Theory and Practice of Medicine at the Stanford University School of Medicine, is one of the most accomplished and admired physician educators today. His pieces have appeared in The New York Times and The Wall Street Journal, and one of his recent articles, entitled Culture Shock, …
Believe it or not, there are such instances.
Peter Ubel tells us of one, in a sad case of end-stage metastatic lung cancer. While observing a patient and his wife arguing about his cigarette use, Dr. Ubel realizes that in this instance, it’s quality of life that matters.
So, instead of watching them fight, he encourages them to see the bigger picture: “My duty as a …
Physicians are often pressed for time, both in the hospital and the clinic.
And for those who don’t speak English, that represents a huge problem. Not only are many cash-strapped hospitals cutting back on interpreter services, those that have them aren’t always being utilized.
As surgeon Pauline Chen notes, “Patients who speak English poorly or not at all face longer hospital stays, an increased risk of …
New York City mayor Michael Bloomberg recently introduced an initiative to pressure the food industry to cut salt intake by half over the next decade.
Combined with the city’s ban on trans-fats and move to post calorie counts in restaurants, this is part of an emerging trend where the government is taking decisive steps to control what we eat. But, in the case of salt – to what end?
Read more…
Abraham Verghese is an internal medicine physician at Stanford, and a prominent physician-writer.
Stanford University is utilizing Facebook as a way to ask Dr. Verghese questions. He’s one of the most eloquent and introspective doctors working today, so it’s a treat to hear him talk about the various issues readers bring up.
Here are the first few videos in the series.
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